Organization
SANDY J. KIMMEL, D.O., P.A.
Active
Parent organization
SANDY J. KIMMEL, D.O, P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SANDY J. KIMMEL, D.O, P.A.
Authorized official
MRS. BONNIE DONLEYCOTT (OFFICE MANAGER)
(919) 872-0390
Entity
Organization
Contact information
Practice address
3400 EXECUTIVE DR, SUITE 203, RALEIGH, NC 27609-7476
(919) 872-0390
(919) 872-0391
Mailing address
3400 EXECUTIVE DR, SUITE 203, RALEIGH, NC 27609-7476
(919) 872-0390
(919) 872-0391
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
200400893
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598714313
INDIVIDUAL NPI NUMBER
NC
05
—
89137PC
—
NC
Enumeration date
03/22/2007
Last updated
01/12/2011
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